Teenage Scoliosis Associated with Low Bone Quality

A new research study published in the Journal of Manipulative Medicine in July 2015, reveals that bone

quality is lower in teenagers suffering from adolescent idiopathic scoliosis (AIS) (1). This study measured ultrasound sound waves traveling through the bones to compare bone quality to conduct sound in two groups, patient with AIS and control patients with no scoliosis.

In general the patients in the AIS group had lower measured sound values compared to the control group indicating they had a lower bone quality compared to individuals without scoliosis. In addition, 25% of the AIS group were found to have low bone quality however the curve type and magnitude of the curve were not shown to be a factor in bone quality. There was also a correlation found in bone quality between those in the AIS group that had begun menstruation and those that had not begun menstruation.

The researchers concluded that AIS patients may have lower bone quality due to slower bone maturation. However, I think more research needs to be conducted on the "WHY" they have a slower bone maturation, but I do have a hypothesis to present. In many of the children and adult with scoliosis that I've seen in my office, there are some serious nutritional deficiencies and gut flora imbalances that can lead to reduced growth and healing rates as well as impact muscle function that can contribute to spinal curvatures.

For instance, there have been studies that have linked low levels of Vitamin D with AIS (2). There has also been research on melatonin deficiency linked to AIS, however some controversy exists as circulating levels of melatonin are no different for those with or without AIS but the osteoblasts (bone building cells in bones) melatonin signaling in those with AIS shows impairment and distinct mutations that can effect melatonin signalling. (3) This last study looking at melatonin and mutations may yield more information about a genetic factor for scoliosis as in some cases you may see this conditions run in families.

In moving forward with a more active care approach to scoliosis, I think practitioners need to focus on an integrative treatment approach blending chiropractic care to restore joint mobility, diet and nutritional assessments to check for nutritional deficiencies and make dietary recommendations, and functional exercise aimed at balancing spinal musculature bilaterally to restore normal posture and positioning would be the best answer to a multi-facted problem. Our current medical approach of watch and wait until it gets bad enough to require surgery (which is a completely different issue in itself) is NOT good enough. Every patient deserves to know their options when it comes to their health including alternative care options and they should DEMAND to make an informed choice on what treatment(s) they will consent to.

Resources:
1. Du et al. "Qualitative Measurements of Bone Quality in Female Adolescents with Idiopathic Scoliosis Compared to Normal Controls". J Manipulative Physiol Ther. 2015 Jul 18. pii: S0161-4754(15)00074-3.

2. Batista et al. "Association between Vitamin D levels and Adolescent Idiopathic Scoliosis". Scoliosis. 2014; 9(Suppl 1): O45. Click Here to Read More

3. Moreau et al. "Melatonin Signaling Dysfunction in Adolescent Idiopathic Scoliosis". Spine (Phila Pa 1976). 2004 Aug 15;29(16):1772-81. Click Here to Read More

Chiropractic Care Is Mandated Before Surgery

Back pain is a common occurrence in America today due to our sedentary lifestyles, poor posture, obesity rates, and core muscle weakness. According to experts, 4 out of 5 Americans will experience low back pain at least once in their lifetime and low back pain is the second most common reason, behind the common cold, for a doctor's visit. This condition can be debilitating and lead to difficulty with every activity of daily living and can cause also contribute to lost wages and financial burdens on family members. According to the American Academy of Pain Medicine, pain costs put a burden of approximately 560 to 635 billion dollars in the US with a combination of medical costs and economic costs related to disability, wages, and productivity.

In May of 2012, the Pittsburgh Medical Center Health Plan released new guidelines for the management of chronic low back pain that included a mandate requiring all surgical candidates to have tried 3 months of conservative care consisting of chiropractic care, physical therapy, medication, and a low back pain health coaching program before surgery. These standard guidelines will be enforced in 15 counties in Pennsylvania, 20 hospitals, and over 400 doctors' offices and outpatient facilities. Administrators are hoping to cut down the use of costly spinal surgery which in many cases can actually cause conditions to worsen rather than a more conservative approach in care that can address and manage about 70% of low back cases. Want more information on their mandate?

This trend will be on the rise in the next few years throughout the world as more research is being put to the test in verifying the benefit of conservative care before surgery. In a recent review at ENEVE, a chiropractic college in Mexico, spinal surgery numbers were found to be reduced and back pain relieved when chiropractic care was sought out before surgery. Chiropractic is a resoundingly good resource for people suffering from low back pain, because it will focus on restoring nervous system function and also address the weakened or injured musculature and soft tissue involved in the pain and disability created from back pain. If you're suffering from back pain and are considering surgery, I'd highly recommend visiting a chiropractor for a minimum of 3 months of treatment before scheduling a surgery. Surgery in many cases is not reversible and may result in an increase of symptoms and degeneration over a period of time. Want more information?

Would you like to schedule a consultation to learn more about how chiropractic can help you achieve your health goals? Click on "Make Appointment" on the right side of the screen.